“Antibiotics that can save lives are becoming ineffective. Part of the problem is that these critically important drugs are misused and overused in the food-producing animal sector for commercial gains. The covid-19 pandemic has re-emphasised the importance of medicines that can treat – we must conserve these medicines before this silent pandemic of antimicrobial resistance swamps us completely,” said Sunita Narain, director general, Centre for Science and Environment (CSE). Narain was speaking at an international webinar organised by CSE on Friday evening on conserving the use of critically important antimicrobials in food-producing animals to contain growing antimicrobial resistance (AMR).
This webinar was the first in a series of interactions planned and led by CSE to discuss the need for coherence in global guidance, as highlighted by CSE in its new report — Conserving the use of critically important antimicrobials: gaps and possibilities in global guidance and Indian policy framework. “There is a need for coherence in global guidance on the use of these antimicrobials. Countries will struggle to take effective action unless a clear and uniform message is given to them by all the different agencies involved,” Narain added.
Antimicrobial resistance is an ongoing public health crisis which, if not contained aggressively, is expected to cause catastrophic damage to human-health, animal-health, food productivity, livelihood and attainment of several sustainable development goals (SDGs). Critically important antimicrobials as defined by the World Health Organization (WHO) are the sole or one of the limited available therapies to treat serious bacterial infections in humans.Use of antibiotics can lead to AMR, but one big part of the problem is that those considered critically important for humans are misused and overused in food-producing animals for reasons other than treatment, which are avoidable.
The webinar was addressed by a panel that included – besides Sunita Narain — Peter Beyer, unit head a.i., AMR Global Coordination Department, WHO; Junxia Song, senior animal health officer, Food and Agriculture Organization (FAO); Olafur Valsson, AMR liaison officer, Antimicrobial Resistance and Veterinary Products Department, World Organisation for Animal Health; J Scott Weese, professor, Ontario Veterinary College and director, Centre for Public Health and Zoonoses, University of Guelph, Canada; and Amit Khurana, programme director, Food Safety and Toxins, CSE.
What does the CSE report say
The CSE report highlights three key issues in the global guidance of tripartite organisations — WHO, FAO, and the World Organisation for Animal Health (OIE) – which are guiding countries to combat AMR. These are:
- Need for a significant overlap in antimicrobials considered critical for humans and food-producing animals
- Need for coherence in position on use of critically important antimicrobials
- Need for clarity and strong action on use of antimicrobials for disease prevention.
Speaking at the webinar, Olafur Valsson acknowledged the lack of coherence: “The general direction of the tripartite is not aligned. We are working together and also more closely with the United Nations Environment Programme (UNEP) to address this issue. We are working on a tripartite strategic framework to align our work on all aspects of our response to AMR.”
“The issue of disease prevention is a murky area. People tend to subsume whatever they want to call prevention under the issue—earlier it was growth promotion and later it was sub-therapeutic doses administered on a daily basis. But such use is actually abuse,” added Peter Beyer.
Stressing the need to take the fight to the ground, J Scott Weese says, “Wherever we can, we should make an effort to ensure antimicrobials are not used, because they are obviously overused. We need to promote the use of drugs that cause the least damage. We need to educate our way out of antimicrobial overuse.”
In the report, CSE researchers point out that sending out a coherent message is particularly important for low- and middle-income countries of the Global South, which are dependent on the global guidance. Says Amit Khurana, the lead author of the report: “The CSE report recommends that the WHO-FAO-OIE Tripartite should consider developing a uniform and strong guidance on the use of critically important antimicrobials across all food-animal sectors. It should also focus on concerted interventions to develop a good understanding of global- and country-level use of critically important antimicrobials and resistance against them in animals and humans, along with linkages.”
Earlier this week, the Global Leaders Group on Antimicrobial Resistance (GLG) also called upon countries to markedly reduce the overall use of antimicrobials, particularly the highest priority critically important antimicrobials for terrestrial and aquatic animals and plants.
“We need to change the way we are producing our food. We have to work towards food systems which are less dependent on chemicals. Countries in the Global South cannot afford to first chemicalise and then spend money to clean up,” says Narain, who is also a member of the Global Leaders Group on AMR.
The CSE report also presents practices and policy gaps in India related to antimicrobials considered critical for human health, but used in food-producing animals.It exposes the use of several critically important antibiotics in the poultry, dairy and aquaculture sectors in the country. It also highlights gaps in policies and recommendsdeveloping a roadmapfor different food-producing animals and changes required in policies, regulations, standards and guidelines, in addition to creating awareness, building capacity and better enforcement.
( Reported by Pratyusha Mukherjee, BBC Journalist based in Kolkata.)